7. The Unstable Cervical Spine

  1. Ian Johnston2,
  2. William Harrop-Griffiths3 and
  3. Leslie Gemmell4
  1. Michelle Leemans and
  2. Ian Calder

Published Online: 10 NOV 2011

DOI: 10.1002/9781118227978.ch7

AAGBI Core Topics in Anaesthesia

AAGBI Core Topics in Anaesthesia

How to Cite

Leemans, M. and Calder, I. (2011) The Unstable Cervical Spine, in AAGBI Core Topics in Anaesthesia (eds I. Johnston, W. Harrop-Griffiths and L. Gemmell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118227978.ch7

Editor Information

  1. 2

    Raigmore Hospital, Inverness, UK

  2. 3

    Imperial College Healthcare NHS Trust, London, UK

  3. 4

    Wrexham Maelor Hospital, Wrexham, UK

Author Information

  1. The National Hospital for Neurology, and Neurosurgery, London, UK

Publication History

  1. Published Online: 10 NOV 2011
  2. Published Print: 29 NOV 2011

ISBN Information

Print ISBN: 9780470658628

Online ISBN: 9781118227978



  • unstable cervical spine;
  • ‘cervical spine instability’;
  • anaesthesia for ‘unstable’ spine;
  • spinal cord perfusion;
  • cervical spine instability;
  • instability, neurological;
  • Down's syndrome, Klippel-Feil;
  • Grisel's disease, ‘wry neck’ of the young


• The term ‘cervical spine instability’ is an imprecise one.

• Using airway management techniques that minimise spinal movement is sensible; however, securing the airway takes precedence over maintaining cervical immobility.

• Maintain spinal cord perfusion with careful positioning and the use of intravenous fluids and vasoconstrictors to maintain arterial blood pressure.

• Most reports of spinal cord injury after anaesthesia have been in patients with spinal canal stenosis rather than cervical instability.